PROM,AROM,AAROM,PAROM

1. APPLIED SCIENCES
of
ROM EXERCISES

2. TYPES OF ROM EXERCISES
Passive ROM. Passive ROM (PROM) the unrestricted ROM that is produced entirely by an
external force; there is little to or no voluntary muscle contraction. The external force may be
from gravity, a machine, another individual, or another part of the individual’s own body.
Active ROM. Active ROM (AROM) is movement of a segment within the unrestricted ROM
that is produced by active contraction of the muscles crossing that joint.
Active-Assistive ROM. is a type of AROM in which assistance is provided manually or
mechanically by an outside force because the prime mover muscles need assistance to
complete the motion

3. PRINCIPLES AND PROCEDURES FOR APPLYING ROM
TECHNIQUES
1. Examine and evaluate the patient’s impairments and level of function, determine any precautions and prognosis,
and plan the intervention.
2. Determine the ability of the patient to participate in the ROM activity and whether PROM, A-AROM, or AROM can
meet the immediate goals.
3. Determine the amount of motion that can be safely applied for the condition of the tissues and health of the
individual.
4. Decide what patterns can best meet the goals. ROM techniques may be performed in the
a. Anatomic planes of motion: frontal, sagittal, transverse
b. Muscle range of elongation: antagonistic to the line of pull of the muscle
c. Combined patterns: diagonal motions or movements that incorporate several planes of motion
d. Functional patterns: motions used in activities of daily living (ADL)
5. Monitor the patient’s general condition and responses during and after the examination and intervention; note
any change in vital signs, any change in the warmth and color of the segment, and any change in the ROM, pain, or
quality of movement.
6. Document and communicate findings and intervention.
7. Re-evaluate and modify the intervention as necessary.
Examination, Evaluation, and Treatment Planning

4. Patient Preparation
1. Communicate with the patient. Describe the plan and method of intervention to meet the goals.
2. Free the region from restrictive clothing, linen, splints, and dressings. Drape the patient as necessary.
3. Position the patient in a comfortable position with proper body alignment and stabilization but that also
allows you to move the segment through the available ROM.
4. Position yourself so proper body mechanics can be used

5. Application of Techniques
1. To control movement, grasp the extremity around the joints. If the joints are painful, modify the grip, still providing support
necessary for control.
2. Support areas of poor structural integrity, such as a hypermobile joint, recent fracture site, or paralyzed limb segment.
3. Move the segment through its complete pain-free range to the point of tissue resistance. Do not force beyond the available
range. If you force motion, it becomes a stretching technique.
4. Perform the motions smoothly and rhythmically, with 5 to 10 repetitions. The number of repetitions depends on the
objectives of the program and the patient’s condition and response to the treatment

6. INDICATIONS AND GOALS FOR ROM
1. Acute, inflamed tissue, passive motion is beneficial; active motion would be detrimental to the healing process.
Inflammation after injury or surgery usually lasts 2 to 6 days.
1. When a patient is not able to or not supposed to actively move a segment or segments of the body, as when comatose,
paralyzed, or on complete bed rest, movement is provided by an external source.

7. Goals for PROM
1. Maintain joint and connective tissue mobility
2. Minimize the effects of the formation of contractures
3. Maintain mechanical elasticity of muscle
4. Assist circulation and vascular dynamics
5. Enhance synovial movement for cartilage nutrition and diffusion of materials in the joint
6. Decrease or inhibit pain
7. Assist with the healing process after injury or surgery
8. Help maintain the patient’s awareness of movement

8. Other Uses for PROM
1. When a therapist is examining inert structures, PROM is used to determine limitations of motion, to determine joint
stability, and to determine muscle and other soft tissue elasticity.
2. When a therapist is teaching an active exercise program, PROM is used to demonstrate the desired motion.
3. When a therapist is preparing a patient for stretching, PROM is often used preceding the passive stretching techniques

9. Active and Active-Assistive ROM
1. Whenever a patient is able to contract the muscles actively and move a segment with or without assistance, AROM is used.
2. When a patient has weak musculature and is unable to move a joint through the desired range (usually against gravity), A-
AROM is used to provide enough assistance to the muscles in a carefully controlled manner so the muscle can function at its
maximum level and be progressively strengthened. Once patients gain control of their ROM, they are progressed to manual
or mechanical resistance exercises to improve muscle performance for a return to functional activities
3. AROM can be used for aerobic conditioning programs.
4. When a segment of the body is immobilized for a period of time, AROM is used on the regions above and below the
immobilized segment to maintain the areas in as normal a condition as possible and to prepare for new activities, such as
walking with crutches.

10. Goals for AROM
1. Maintain physiological elasticity and contractility of the participating muscles
2. Provide sensory feedback from the contracting muscles
3. Provide a stimulus for bone and joint tissue integrity
4. Increase circulation and prevent thrombus formation
5. Develop coordination and motor skills for functional activities

11. PROM
Upper Extremity Shoulder: Flexion and Extension
Hand Placement and Procedure
1. Grasp the patient’s arm under the elbow
2. with your lower hand. With the top hand, cross over
and grasp the wrist and palm of the patient’s hand.
3. Lift the arm through the available range and return
NOTE: For normal motion, the scapula should be free to rotate
upward as the shoulder flexes. I
Flexion

12. PROM
Upper Extremity Shoulder-Extension

13. PROM
Shoulder: Abduction and Adduction
Hand Placement and Procedure
Use the same hand placement as with flexion, but move the
arm out to the side. The elbow may be flexed
NOTE: To reach full range of abduction, there must be external
rotation of the humerus and upward rotation of the scapula